PatientHandbook5A

PATIENT
HANDBOOK
Healthcare for the Whole Family
(352) 563-5070
impwellnesscenter.com

Health is a state of complete physical
mental and social wellbeing not merely
the absence of disease or infirmity.
Internal Medicine & Pediatrics
Wellness Center... A Patient Centered
Medical Home
You will always be treated with sincere
compassion and friendliness

Our Providers
Carlene Wilson
Physician
Dr. Carlene Wilson is a
woman with a deep commitment
to family and the service of others.
These values were shaped early
in life as she was
raised in Jamaica
within a Christian
environment. As
a Christian it is
instinctive for her
to be engaged in
activities to help
the less fortunate in
the community. As
far back as she can
recall she has always
wanted to be a
doctor. What better
way to satisfy her innate curiosity
and desire to help others?
Dr. Wilson has had a
successful career in the field
of medicine. At each stage of
her career she has managed
to distinguish herself as being
beyond the average physician and
has received numerous accolades
for her hard work and dedication.
Board Certified in both Internal
Medicine and Pediatrics.
Dr. Wilson is a Member of the
American College of Physicians,
American Academy of Pediatrics,
and the American Soceity of
Bariatic Physicians. She graduated
in 1997 from the University Of
the West Indies in Jamaica, where
she received several honors. After
a few years in general practice she
pursued specialty training at the
Yale Univeristy-
Bridgeport Hospital
Combined Internal
Medicine and
Pediatrics program.
She continued to
excel academically
and with patient
care. She ultimately
served as the
programs Chief
Resident from 2003
to 2004. In 2011
She was selected as
one of the areas Top
Doctors appearing in the Ocala
Magazine.
Dr. Wilson is about more
than just work, her family is of
the highest priority. She enjoys
spending time with her husband
and their three little boys. When
work is all over, she dabbles in
the kitchen trying to recreate
dishes seen on TV or eaten in a
restaurant. One day she hopes
to cook with organic vegetables
grown in her backyard.

Joy Dowe
Family Nurse Practitioner
Joy is a Board Certified Family
Nurse Practitioner. and is a graduate of
the University of Central Florida. She
has a keen interest in Natural remedies
and has studied this at the....
Joy has been a health care
professional for more than fifteen
years. First as a nurse working mainly in the Emergency Room, and
now as a nurse practitioner. She provides excellent care for her patients
because of her knowledge, insight, and compassion. More than just
work she enjoys the outdoors and adventure. From kayaking, to fishing
and biking. She is also a successful gardener and a great cook.
Donna Scarbrough
Family Nurse Practitioner
Donna is a Board Certified Family
Nurse Practitioner and is a graduate of the
Mid West School of Midwifery. Donna has
been a health care professional for over 20
years in a variety of specialties including:
Adult, Home Health, Pediatrics, Newborn
Nursery, Postpartum and Emergency
Room. She became a full-time member of
our healthcare team June 2011 as a nurse
practitioner. Although, she adores her
mature patients she loves the Pediatric
aspect of the practice and hopes to see it expand. Donna enjoys camping,
laughing andjust spending time with her husband and 2 grown children.

Things You Should Know
Appointments
Patients are seen by appointments.
If you cannot make your
appointment, please call the office
to cancel avoiding a $25 No Show
charge if you do not call to cancel.
We work to see you at your
scheduled time barring emergencies.
If you have not been attended
to within 15 minutes of arrival
please alert the receptionist.
For your comfort we have
separate seating areas for our
clients. Well family’s are seated
in the play room. Well adults are
seated in the Large waiting room.
Sick adults and children are
seated in our family room left of the
reception desk.
Visit Types
As your primary care provider,
we will perform a comprehensive
physical/well visit annually. At this
visit we will identify risk factors and
barriers to your having a healthy
life. You will be provided with a
Plan of Care and recommendations
to include cancer screens and
immunizations. Most insurances
strongly recommend this and will
cover your visit. If you are underinsured
please make arrangements
with our Billing Department.
Chronic Disease Management
or Routine office visits are when
we will review your chronic
diagnoses such as Asthma, and
refill medications review test results
etc.. The recommended intervals
for you appointments are based on
best practice standards to ensure
your safety.
A Sick visit, or a Physical does
not negate your Chronic Disease
Management/regular.
Attendance at a group visit/class
for chronic disease management
can negate a regular office visit.
Medication
For your safety prescriptions
requests will be handled during
office hours. Narcotics will never be
called in outside of office hours.
Medications are reviewed and
refills provided at your office visit.
Please bring medication bottles to
your appointment for verification.
Call backs for refills after an
appointment will be charged $10.
For your convenience we dispense
some medications in the office . This
saves you a trip to the pharmacy
when you least want to go.
Diagnostic Services
We do on site lab draws Monday
to Friday 7:30-8:30 am. We will call
with all test results if you do not
have a follow-up appointment to
review them. This includes normal
results. If you do not receive a call
within 2 weeks of any test please
call for your results.

As part of our commitment
to primary prevention and early
detection of disease we off cardiac
screening as appropriate and lung
function testing
Financial Policy
Your medical insurance is a
contract between you and your
insurance company. You are in fact
responsible for ensuring that your
accounts are in good standing. As
a courtesy to you we will file your
insurance claims for all appropriate
medical expenses.
If there are delays with payment
we will advise you of this. Co-Pays
and deductibles are expected
in full at the time of service .If
necessary alternate arrangements
can be made prior to your visit. For
your convenience payments can
be made with cash check debit or
credit cards.
Weight Management
At IM&P Wellness Center, we
recognize that being overweight
is a complex medical problem that
requires a customized treatment
approach designed to meet each
individual’s lifestyle and health
issues. Our Programs have been
shown to reduce blood pressure,
control blood sugars and decrease
medication use.
We offer the acclaimed OPTIFAST
meal replacement program. This
replaces your normal diet with
calorie and portion controlled
shakes, bars and soups fortified
with all required nutrients. With
this you can safely loose 2-7
pounds per week.
Our Traditional food allows
maximal flexibility and utilizes
foods you prepare at home. This
plan can also incorporate some
meal replacement products for
greater portion control.
Medications and Supplements
are used as appropriate to assure
compliance and augment weight
loss.
Skin Care Program
We are pleased to provide a long
term solution to all your aesthetic
and cosmetic care needs. We use
only the latest technology that
has demonstrated lasting results
while keeping to the highest of
safety standards. We are able
to treat issues such as wrinkles,
rosacea, acne, sunspots, unwanted
skin pigmentation, spider veins
and excess hair through the latest
in medical laser technology and
innovative skin care products.
Consultations with our Clinic
Aesthetician are free.
Bio-Identical
Hormone Therapy
Bio-identical Hormone
replacement
We offer the options of getting
hormones tested and replaced
using bio-identical hormones
formulated to match your needs.
Allowing the Menopause phase of
life to be a pleasant transition.

Communications Center
Call (352) 563-5070 and you will be routed based on your selection to
the person best able to assist you. In the event they are immediately
unavailable please leave a message and your call will be returned
within an hour.
Office Hours
Monday to Friday 8:00 AM to 6:00 PM
Lunch from 12:00 to 1:00 PM
Main Number: 352 563 5070
When Calling –PRESS:
Appointments
Refills
Results
Billing
Directions
Weight Loss
Speak with an
assistant. Will ring up
to 90 seconds or until
an assistant answers.
If no one answers,
please leave a
message this will be in
our general mailbox.
We will do our best to
return your call within
an hour.
Skin Care
Repeat Options
After Office Hours
Call 352 563 5070
All options above are available. Your call will be responded
to on the next Business Day.
PRESS : To Reach the Doctor on Call. Your call will
be returned within an hour. If you have a phone that does
not accept blocked calls you must unblock it while waiting
for our call. If you do not get a response Call (352) 621-7379.

Reminder calls
Please provide us the number
you check most frequently. This
may be your cell phone. Let the
front desk staff know that this
is your MAIN number. We will
usually call 48 hours prior to
your appointment to give you
an opportunity to confirm.
Preventive Health Reminders
such as needed physicals,
immunizations, mammogram
will also be called.
Text Messages may
sometimes be sent.
Email
The Patient Portal is the most efficient way
to communicate with us via email.
General Mail
Internal Medicine & Pediatrics Wellness Center
6038 W Nordling Loop
Crystal River Fl, 34429
Payments
Internal Medicine & Pediatrics Wellness Center
P.O. Box 2012 • Lecanto Fl
Reminders
Email Reminders
Use of our Preferred Facilities
and having a Patient Portal
Account will allow you to get
early notification on results and
services that affect your care.
Post Cards
You may also receive various
reminders in your mail.
Special Needs
If you are unable to access the
internet, handle your phone
calls and want your children
or parents to be contacted
instead of you please provide
the contact information for
the appropriate relative.

Preferred Facilities
These facilities accept most insurances however you must verify at the
time of service that they are still a participating provider with your insurance
company. Selected facilities have a form of data transfer that is
compatible with our electronic charts for enhanced efficiency. We have
no financial relationships with them.
RADIOLOGY SERVICES
Crystal River
Seven Rivers Regional Medical
Center
6201 N Suncoast Blvd
Crystal River, FL 34428
www.srrmc.com
Ph (352) 795-8394
Fx (352) 795-8303
Citrus Diagnostic Center
922 N. Citrus Avenue
Crystal River, FL 34428
www.citrusdiagnosticcenter.com
Ph (352) 795-9200
Fx (352) 795-6460
Dunnellon
Dunnellon Diagnostics
(Associated with Sev Riv Hosp)
11673 N Williams Street
Dunnellon, FL 34433
www.srrmc.com
Ph-(352) 489-7211
Fx-(352) 489-7311
Homossassa
Homosassa Open MRI
8464 W Aquaduct Street
Homosassa, FL 34448
www.hmri8464@hotmail.com
Ph (352) 628-4800
Fx (352) 628-4801
Sugar Mill Diagnostic
8303 S Suncoast Blvd
Homosassa, FL 34446
www.smdi.net
Ph (352) 628-9900
Fx (352) 628-9700
Inverness
Inverness Medical Imaging
2105 Hwy 44 W
Inverness, FL 34453
No Website Available
Ph (352) 637-6100
Fx (352) 637-6900
Ocala
Advanced Imaging
300 SE 17th St Bldg 800
Ocala, FL 34471
www.hcahealthcare.com
Ph (352) 867-9606
Fx (352) 622-3795
MRI Bldg 300.
Ph (352) 867-7205
Fx (352) 867-8488
Munroe Regional Medical Center
1500 SW 1st Avenue
Ocala, FL 34471
www.monroeregional.com
Ph (352) 402-5111
Fx (352) 402-5110

Laboratories
Quest appointments can be made throughout the USA by calling:
1-888-277-877 or visiting questdiagnostics.com.
Labcorp appointments can be made throughout the USA by calling:
800-877-3818 or visiting: www.labcorp.com
Crystal River
Labcorp
580 SE 7th Avenue
Crystal River, FL 34429
Ph (352) 564-8760
Fx (352) 564-0776
Quest Diagnostics
6199 W Corporate Oaks
Dr
Crystal River, FL 34446
Ph (352) 795-0020
Fx (352) 563-5238
Homosassa
Quest Diagnostics
8287 S Suncoast Blvd
Homosassa, FL 34446
Ph (352) 382-0355
Fx (352) 382-3067
Inverness
Labcorp
2525 Gulf to Lake Hwy
Inverness, FL 34453
Ph (352) 726-0913
Fx (352) 341-0189
Quest Diagnostics
210 S Apopka Ave
Inverness, FL 34452
Ph (352) 637-1020
Fx (352) 344-8427
Ocala/Dunnellon
Labcorp
9401 SW State Rd 200
Bldg 1000 Ste 1002
Ocala, FL 34481
Ph (352) 861-0681
Fx (352) 861-3857
Labcorp
2100 SE 17th
St Ste 901
Ocala, FL 34471
Ph (352) 732-0751
Fx (352) 732-4917
Quest Diagnostics
8602 SW St Rd 200 Ste J
Ocala, FL 34481
Ph (352) 873-9044
Fx (352) 873-0069
Quest Diagnostics
303 SE 17th; St Ste
101-A
Ocala, FL 34471
Ph (352) 732-3060
Fx (352) 732-0837
Quest Diagnostics
2910 SE 3rd Ct Ste B
Ocala, FL 34471
Ph (352) 351-9244
Fx (352) 732-9511
Quest Dunnellon
11371 N Williams St #2
Dunnellon, FL 34432
Ph (352) 465-2757
Fx (352) 465-2787
Ask about our Skin Care Products.

Frequently Asked Questions
What type of practice is this?
We are Primary care facility that treats adults and children we are staffed by an
Internist, Pediatrician and Family Nurse Practitioners.
We also provide Weight Management, Esthetic skin care, Bio- Identical
Hormones, and some Naturopathic care.
PROVIDERS
Who are your providers?
Dr. Wilson is Board certified in Both Internal Medicine and Pediatrics.
Joy Dowe and Donna Scarbrough are Board Certified Nurse Practitioners in
Family Medicine. You can read more about them on our website.
What is a Nurse Practitioner?
A Nurse Practitioner has at least a Masters Degree and has taken courses to
train them in the prevention, diagnosis, and treatment of disease relevant to
their chosen specialty. They are able to work without a medical doctor and
are found in many clinics throughout the country. Some may have worked
as nurses before changing careers. That nursing experience is an invaluable
asset in the way they provide care when compared to a medical doctor. In our
practice our Practitioners work independently but also have immediate access
to Dr. Wilson for consultations on cases that concern them.
APPOINTMENTS
Do I have to schedule my appointment when I am leaving?
We prefer you do this so that you can get the provider and time of your
choice. Last minute appointments make it difficult to get your provider of
choice. We do not overbook our schedules .
Can my husband and I be seen at the same time?
Yes and No. You can be seen at the same time slot by different providers. If
you wish to see the same provider or be in the room for each others visit.
There will be someone scheduled between you.
Why can’t I always see Dr Wilson for my appointment?
If there is an opening on her schedule you will be able to see her. However since
her schedule is filled up a few weeks out, you are less likely to see her when
you call for an appointment within a few days. The Nurse Practitioners who
sees you, will interrupt her if they believe her immediate input on your care is
needed. Less urgent cases are reviewed with her daily.

Why can’t I see the doctor?
The doctor is not available at the time you are requesting, but, we can get you
in today or tomorrow with another provider. If your issue is not urgent you
can wait until the doctor is next available.
WALK IN VISITS
Do you take walk-ins?
Patients are seen by appointment. If there is an opening you are welcome to
wait or you can return closer to the time of your appointment
OFFICE VISITS
How long is a typical appointment?
15 minutes with the doctor, 20 minutes with the Nurse Practitioner. Additional
time depends on the other services being performed each day..
You’re appointment time with the provider is the time we expect to start
your visit. This begins with the interview at check-in when your contact
information and insurance is verified and continues with Triage when the
Nurse/MA reviews all your medications, changes from specialist doctors,
updates your social and family risk factors. Procedures or vaccines may be
performed per our protocols before you see the provider. You will then see the
provider alone or with a group.
Why do I have to come in every 3 months?
Regular appointment intervals vary from 3,4, 6, 12 months. The intervals
are based on a careful consideration of several factors including your age,
diagnosis, risk factors, and number of prescription medications you are
on. You may also be asked to return to review abnormal test results. These
appointments are critical to your heath. Without them we will not be able to
identify medication side effects, assess their efficacy and monitor for disease
progression. It is a great day when we see you and are able to say all is well
continue treatment and return in 3 months.
Why do I need a Physical If I am here every 3 months?
The focus in a physical is different from a regular follow-up visit. At a physical
our goal is to identify any new risk factors for disease. Provide screening
services to detect cancer. Provide immunizations to prevent disease. Perform
a comprehensive physical Exam which will include a rectal exam, pelvic and
breast exam if appropriate. There simply is not enough time in a Chronic Care
visit to do this effectively.

If I am in for a sick visit do I still have to come back for my regular Followup
in a few days?
Sometimes. After a sick visit a follow-up maybe needed to ensure resolution
of your symptoms and this can be combined with your already scheduled
Follow-up visit. On the other hand if all your labs and other tests that
will be reviewed at your Regular Follow-up are available at your sick
visit, the provider may address those and cancel the upcoming Follow-up
appointment.
What are group visits ?
Chronic disease Management Success requires education and partnership.
We will have groups of patients with similar medical profiles and cluster their
visits in the same time slot. You will be triaged by the nurse/medical assistant.
The group will then be educated on a component of their disease including
medications. 20 minutes of talk 20 minutes of questions. If you are sick or
have an acute problem you cannot be seen in group that day and will need an
individual appointment.
Can I do my pap at the same time as my 3 month follow-up?
No. To adequately address both issues you will need 2 appointments on the
same day. We cannot guarantee your insurance will pay for 2 visit types on the
same day. Most do not and you could end up being responsible in full for at
least one .
BILLING/INSURANCE
Do you accept my insurance?
We accept most commercial PPO Type insurances. We accept only a few HMO
plans. Visit our website for a complete listing of insurances we accept.
Are we currently accepting new Medicaid / Healthease patients?
No, I’m sorry but our panel is closed. Whenever we have openings we offer
those to family members or existing patients with that insurance.
Does my insurance pay for a physical?
Most insurances do. If your insurance does not you should speak with the
billing supervisor to get a self-pay discount… This is too important to your
care to not have it.

Does Medicare pay for a physical?
Medicare pays for a Wellness Visit which has all the components of our
physical but does not require a physical examination. It also requires
documentation of other services we provide at that time such as home safety
review, dementia screening, Consolidation of specialists and other services. To
prevent 2 visits given the overlaps we address all components at that time and
schedule a greater time slot for the visit.
Does my insurance pay for this test?
We will do our best to verify coverage for any procedure we perform in our
office. However each facility you utilize is responsible for providing you with
an estimated cost of care for services they provide. We are not aware of the
contract they have with your insurance company and so cannot provide you
with that information. If you receive a bill that you disagree with for services
we provided you can discuss this with our billing supervisor. If it is from
another provider we can furnish you a copy of your chart note to appeal for
medical necessity.
Who can I talk to about my insurance/billing?
Ask for the Billing supervisor. Or press option 2 when you call to be
connected to her.
Why do you ask for payment before I even see the doctor?
At check out there will be a lot of activity involved in coordinating your care
and we do not wish to detract from that. Like most other services, payment
must be collected to ensure it can still be provided.
Why is the charge for seeing the Nurse Practitioner the same as seeing the
doctor?
The charge for an office visit includes the cost of staff involved in all stages
of your care from the receptionist to the provider as well as the equipment
and supplies used to care for you. The Nurse Practitioners are highly qualified
Medical Providers able to diagnosis, treat, and prescribe. They are different
from Nurses. Dr. Wilson also reviews and signs chart notes so she is always
involved in your medical care.
*Why did I get a bill after my physical, my insurance
covers physicals at 100%?
Many insurances will cover a physical at 100% . However if during that visit
you receive another service that is not considered preventive care by your
insurance company you will be billed per your insurance guidelines. Other
services may include significant review of labs and medication changes, lesion
removal etc.

REFILLS/MEDICATION
Why can’t I get refills for a year ?
Patients with a history of non-compliance with their care plan, cannot be
given refills for an extended time. This places your health at risk due to the
lack of monitoring. Refills are provided enough to take you to your next
appointment.
Can I get my prescriptions in my hand?
We do not print prescriptions. We only write prescriptions for Class II
controlled substances
Why do you have to send prescriptions electronically?
There is a National initiative for electronic record keeping and prescribing,
to promote patient safety . Eventually every physician, medical facility, and
pharmacy will be expected to comply. A few pharmacies may still not have
all there staff on board with electronic prescribing. If you have any issues
please advice your pharmacy that your doctor’s office sends Prescriptions
Electronically, not by fax. Controlled substances are still faxed.
Why does it take several days to get my medication?
If at the pharmacy your medication is denied by your insurance company,
it is returned to us to file a request for authorization on the medication. If
the provider changes the medication, our office will notify your pharmacy
within 24hours from when we received the denial. If the provider decides
to file the request you will be out a few days most are within 3 business
days from receipt, however some insurance companies take a longer time
to respond. You can call and Press option 3 for Refills to get an update. You
can also receive messages via the patient portal.
Do you have medications on site?
We are able to dispense some acute care medications that will save you a
trip to the pharmacy. We are working with your insurance plans to be able
to dispense your generic medications at your office visit. Please bring your
pharmacy card to your appointments.

RESULTS
Can you fax or mail me a copy of my results?
We do not mail results. We will gladly email you a copy of your results once
they are reviewed. If you register for the patient portal you will get your
results as soon as they are reviewed by the provider.
Can I pick up some of my medical records?
Yes. If you are requesting your medical record there will be a charge of
$1.00 per page with a maximum of $25, To prepare the documents. A CD,
can be prepared for a little less.
Why do I get multiple calls for results?
To provide you the fastest response on your results we will call you as soon
as they are reviewed. However results are returned to the office at different
times. The best way to reduce the number of calls is to sign up for the
Patient Portal.
REFERRALS
Can I schedule my own Referral?
No. We will get an appropriate appointment time based on the nature of
your problem. You are allowed to call and adjust that time if it is not to
your suiting.
Can I chose the doctor I am referred to?
Yes. However we will need to make that appointment if
the referral is from us. Depending on your insurance
you can self refer to certain specialists.
Why do I have to look up the
specialist’s information?
We maintain a list of specialist
that we choose to refer to
based on insurance plan and
experience with their office.
If you do not wish to see a
specialist we recommend you will
need to provide us with the contact
information for an alternative person.

Medical
Suites designed
with the comfort
of Home.
Healthcare
for all Ages.

Greater Access
And More Control
Over Your Health
Information
The patient portal is an innovative and convenient way of
giving you greater access to us and more control over your health
information. You can spend more time sitting at home and less
time filling out forms in the office.
Our Portal uses secure encryption algorithms and multiple
layers of security to safeguard your information. An account and
password is required to access your information.
You do not have to give this information to anyone
including our office.
You can use your portal to:
• Update Your Contact and Insurance information
• Request Appointments
• Request Refills
• Receive Result Notifications
• Receive Reminders about your appointments
• Ask a Question of Nurse and
others in office
• Pay Bills online
• Prepare for your visit by completing
the forms we need
• Maintain your Personal Health Record
• Activate an Emergency Responder card so doctors and
hospitals can access
• your personal health record in case
of an emergency

We hope you enjoy the convenience of communicating with us at
your own pace! To get started you will be sent an email invitation
from patientservices@impwellnesscenter.com Please add this address
to your safe email list. In the email will be a link that says “Click Here”
which will take you to our new patient portal to activate your account.
Once you click the activation link you will be taken to the portal login
screen where you will verify the following information:
Name: Will automatically populate
Email: Will automatically populate
Date of birth: ___________
Zip code: _______________
Once your account is verified you will create your user profile and
choose a USER ID and PASSWORD. Please make note of your login
credentials for future use.
* Please note that your USER ID will need to be unique and contain at least 6
characters.
TIPS:
• If you have a common last name please do not use your first initial
and last name as it is most likely already in use, try adding a number.
* Your PASSWORD must also have at least 6 characters and include
one number OR uppercase letter.
If you need assistance you can click on the HELP button which is
located in the top right hand corner.

Preparing for Your Visits
Weight Managment
A. Initial Visit
Your initial visit will consist of a complete history and physical exam to asses
your mental and physical status before starting the program.
Labs required : Complete blood count (cbc) Comprehensive metabolic panel
(cmp) Lipid Panel Thyroid function Tsh w/ Reflex to T4. Within the past
month. 12– lead Within the last 3 mths.
B. Week One
Your week 1 appointment will include a Resting Metabolic Rate (RMR)
analysis . You are advised to complete the RMR sheet prior to your
appointment. Please remember to fast for 4 hour prior to this appointment.
C. Follow-up Visits
1. Clinic hours are from 10 am to 6 pm
2. Weekly: When you come in for
clinic you will check in with the
receptionist.
3. You will be given a:
Products Order form.
4. Once you complete it, return the
form to the receptionist.
5. Product payment will be due then.
6. You may then have a seat in the
waiting room.
7. The Medical Assistant will call you
in to obtain your weight, B/P
and pulse.
8. If you are due for any lab work or a
visit with your physician the
Medical Assistant will take you to
the exam room or draw your lab.
9. You will then proceed to check out
after your visit where your
products will be waiting for you.
Pediatric Physicals
Visit our website at: impwellnesscenter.com/pediatrics to complete
Development Screening using the Chadis button. Review information
on age appropriate vaccines. Assess your childs Dental Risk and
complete consent forms for fluoride application. Also noted that the dental page
is not showing on the web. And the FAQ title is not centered in the tab.
Adult Physicals and Wellness
Visit our website at: impwellnesscenter.com/adults. You will find a wellness
report for males or females. Complete as best you can and submit or bring the
report to your appointment.
Follow-Up
Bring medication bottles. We need to know the name strength and how you are
taking medications. We need to know how many refills you have. We also need
OTC and natural supplements used. A record of home Blood sugars and Blood
pressures are also needed. Home blood pressure machines should be brought in
at least once pear year to be checked for concordance with our machine. Make a
list of things you need to discuss with the provider and present

A Day At The Office
Planning Your Arrival
In anticipation of
your arrival, a medical
assistant reviews your
chart, looking for labs
procedure or consults
your provider ordered
but we did not receive.
You may receive a call
to this effect. Please
help us by contacting
the appropriate parties.
It is important
that you utilize the
facilities we recommend as this streamlines this process and ensure the
best outcome for you. Some procedures or vaccines that are
due will be scheduled for the same day of your visit, you will
receive a call to advice you of this.
We make every effort to schedule procedures at the
intervals recommended by medicare or other insurance
carriers. Our ability to do this is enhanced when you
provide us correct information on where and what you had done.
On Your Arrival
When you arrive, please sign in at the
counter. The receptionist will provide you with
an electronic Phreesia Pad that allows you
to verify your demographic info, i.e name,
address, insurance, email etc. If you have a
balance, this can be paid at the desk via credit
card using the electronic
Phreesia Pad.
You will be informed of the anticipated
charges for your visit. Payment is due at this time. If
you are unable to make payment, we will ask you to
sit with the billing supervisor in the back office to
discuss this. Questions about coverage or charges
should be directed to the billing receptionist.

Waiting Areas After Check-in
After finding the appropriate waiting area, you will be called either
by the Medical Assistant performing procedures/labs or by one of the
Nurse Practioners to Triage.
Well Adult Room
Far Right (North) of the
Front Desk
Well Child Room
Far left (South) of the
Front Desk
Sick Room
Facing Front Desk

Procedures & Vaccines
Procedures and vaccines are
scheduled per our standard
protocol. Usually, there are
no more than 2 vaccines
per adult and 4 for a
child.
A simple cold is not
a contraindication to
receiving a vaccine. Patients
on steroids, chemotherapy, immunosuppresants
or exposed to someone with these will need to discuss vaccines with the
provider. After your procedure, you will be returned to the appropriate
Waiting Room or seated inside for a provider.
Triage
In triage, the medical assistant needs
to update specific clinical information.
They do not need to know the detailed
history of your illness that information
can be saved for the provider.
Please provide them your main
reason for visit, especially, if you have a
fever, cough, chest pain, shortness of breath,
urine problems or may be pregnant. Your
medication list must be reviewed in
detail…name strength and quantity.
Requests for refills are made
here, but will be verified by the
provider and sent by the provider.
Please inform the assistant at
this point of any new diagnosis,
procedure, surgery, allergy,
hospital or rehab stay since your
last visit. This help’s them better
prepare your chart for the provider
while you wait.

Provider Interview
You will usually be seen by the provider you are scheduled with. On
occasion a provider may have an opening while another is running behind.
You may then be asked to see someone else. You do not have to change to
the
other provider, but we do appreciate your doing this
as it helps us get through a busy day.
All providers follow the same national
standards of care for the chronic diseases we
manage. Where there are shades of grey, Dr.
Wilson has protocols that are followed in our
office by all providers.
The provider’s goal is to assess your
clinical needs, review procedure results and
make recommendations to facilitate the best
outcomes of your health in 15 minutes.
These recommendations will be based
on consideration of the scientific data
that exists your risk factors inclusive
of existing disease and family history,
your mental, emotional and financial
ability to execute the plan.
Procedures
Sometimes after
seeing the provider,
a procedure is
ordered. Please
return to the
front desk billing
receptionist and let her know. She will
then put you on the schedule to have the
procedure done the same day saving a trip.
She will also verify your coverage and costs
associated with the procedure ordered.

Checkout
At this juncture, you will receive
printed educational handouts or have
them sent to your portal account.
You will receive printed orders for
procedures.
Laboratory orders are not
printed since we send those
electronically to Quest or Labcorp
depending on your insurance.
Prescriptions are sent electronically to
your local and or mail order pharmacy.
Follow-up appointments are scheduled at this point.
Clinical
Summary
Within 3 business days
of your appointment,
you will receive a clinical
summary of your office
visit in your portal
account.
1 2 3

Procedures We Recommend
ABP- Ambulatory Blood Pressure.
Done to check patients BP at home
when they have frequent elevations in
the office but report their home BP is
normal.
CAROTID ULTRASOUND
This helps us assess the degree of
blockage in the carotids and thus
helps us to assess ones risk for a
stroke.
LEG ULTRASOUND
This is done in patients who have
pain in the legs when walking, to aid
in the diagnosis of PAD- Peripheral
Arterial Disease.
EKG -Electrocardiogram.
We perform this on all patients with
high blood pressure yearly to check
for heart complications. Also patients
with chest pain to assess heart attack
risk. In the case of palpitations to
check heart rhythm.
We also suggest this for those
at high risk for cardiac disease.
Insurance coverage for these
reasons is usually limited: Men
over age 40 and women over
age 50 with high cholesterol,
cigarette use and family history
of heart disease.
NCT- Nerve Conduction Test
Diabetics are at increased risk
for development of peripheral
neuropathy. This can lead to
increased foot injury. This test
is performed every few years on
diabetics or when there is any change
in sensation n the feet. It is also used
to diagnose Carpal Tunnel syndrome
and various radiculopathies.
PFT – Pulmonary Function Test.
Done to assess lung volumes
HOLTER MONITOR
This is essentially a 24 hour
EKG . It gives a more detailed
analysis of heart beats and
rhythms.
ECHO – Echocardiogram.
This is an ultrasound of the heart.
It is done to assess the valves , heart
muscle and cardiac output. This is
done every 1-2 years depending on
the nature of the heart disease in
patients with valve disorders, heart
failure, heart attacks, stents etc.
which help in the diagnosis and
management of patients with COPD.
Most patient will have this done
yearly or with major changes in
treatment. Smokers with symptoms
should have this done to assess for
COPD.

RMR – Resting Metabolic Rate.
This device measures your oxygen
consumption and calculates the
amount of calories you consumed
while sitting.
This will give the most accurate
measure of your daily caloric needs.
Critical to weight control.
FOB- Fecal Occult Blood.
This is done yearly on everyone over
age 50 to aid with early diagnosis of
colon cancer. It detects blood that is
invisible to the eye.
FLOURIDE APPLICATION
RSV – Respiratory Syncitial
Virus Infection.
This infection in
children under 3 years
old is common in the
late fall through winter. It
viral and being positive can
prevent unnecessary
antibiotic use.
FLU
Influenza is
treated with
antiviral
medication
not
antibiotics.
This tests helps
us
choose the correct agent minimizing
the unnecessary use of
antibiotics.
is
UA – Urinalysis
Done in office to detect bladder
infections and stones.
The fluoride content in our county
water is not sufficient to reduce caries.
Especially in those who use well water.
Children who do not have a dental
home can receive topical fluoride
every 3-6 months to protect their
teeth.
STREP TEST
For patients with Sore throat and
exposure to children. Done to reduce
risk of cardiac complications that
come form untreated strep throat.
EAR WASH
Performed to
remove wax
from the
ears. We
suggest
using
debrox
2 drops
three
times
daily for 4
days . This
sometimes
makes the
procedure
unnecessary.
ALLERGY TEST/SHOTS
We offer skin scratch testing with
the appropriate desensitization
treatments.

Weight-Loss Products
It’s Time to Get Back In Shape
We Recommend These Weight
Managmenent Aids.
Optifast Milk Shakes - Powder and Ready-to-
Drink: chocolate, vanilla and strawberry.
Low Carb Drinks- Hot Cocoa and Fruit flavored.
Protein Bars - Flavors include , chocolate berry
and caramel.
Shakes
Tomato & Chicken Soup
Peanut Butter Chocolate
Breakfast Berry

Caramel Delight
Hot Cocoa Drink
Vanilla Wafer
Hot Cappuccinno Drink
Strawberry Kiwi Drink
Crunch ‘O’s
Sour Cream, Onion or Barbecue
Mixed Berry Drink

SkinCare
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MCT Oil - To aid in fat metabolism.
Citrimax - A natural appetite suppressant.
MICC injections -Vitamin and amino acid injection to boost energy and
curb the appetite.
Glycomannan...............A Gentle Fiber Supplement
D-Mannose...................To reduce Bladder infections
Turmeric.......................To reduce joint pain and inflammation
Co-Enzyme Q10 .........Needs to be repleted with statin use.
Helps promote heart health.
Horse Chestnut
Used to promote healthy veins and reduces the pain
associated with varicose veins.
Primrose Oil.................To reduce symptoms associated with menopause.
Multivitamin................A daily supplement for all adults
Nature’s Medicine

Meadowcrest Office Park
6038 W. Nordling Loop
Crystal River, FL 34429
info@impwellnesscenter.com
Ph (352)563 5070
Fx (352) 795-4322
Services for the
Whole Family
Internal Medicine
Pediatrics
Weight-Loss
Laser Hair Removal
Laser Vein Removal
Laser Facials
BOTOX®
Juverderm®